CVD Risk Factors and Atherosclerosis

Atherosclerosis A multifactorial inflammatory disease Cardiopulmonary 2025 Objectives 1. Outline the steps leading to atherosclerosis and describe how each risk factor contributes to cardiovascular disease (CVD) 2. Advocate for exercise as preventative medicine for each modifiable risk factor for C...

Atherosclerosis A multifactorial inflammatory disease Cardiopulmonary 2025 Objectives 1. Outline the steps leading to atherosclerosis and describe how each risk factor contributes to cardiovascular disease (CVD) 2. Advocate for exercise as preventative medicine for each modifiable risk factor for CVD. 3. Apply the cutoff scores for each risk factor to physical therapy practice to determine precautions for exercise. DESCRIBE THE MAJOR RISK FACTORS FOR CARDIOVASCULAR DISEASE (CVD) KWC,Ch 21 Non-Modifiable Modifiable Name 4 Name 8 CVD Traditional Risk Factors Non-Modifiable Modifiable Age Smoking Sex Obesity Family history Nutrition Race Inactivity Diabetes Cholesterol Triglycerides Stress CVD Traditional Risk Factors  Sex: Male > female Age: Men ≥ __45_yrs Women ≥ __55__yrs Family Hx: First degree relative with MI, coronary revascularization, or sudden cardiac death: Men > ___55___yrs Women > ___65___yrs Race: African-American & Hispanic-American > Caucasian Thresholds for non-modifiable risk factors  Hypertension: 130/80 mmHg or on BP-lowering meds Dyslipidemia: Abnormal blood lipids or on LDL-lowering meds - ”-Statin” ≥ 130 mg/dl LDLc < 40 mg/dl HDLc men 150 mg/dl Triglycerides Obesity BMI ≥ 30 Waist girth men >102 cm; women > 88 cm Insulin resistance ≥ 100 mg/dl fasting blood glucose (126 is diabetes, pre-diabetes is 100) Smoking Current smoker, quit smoking < 6 mo ago, or exposure to environmental tobacco smoke Physical Inactivity < 30 min or moderate-intensity exercise on < 3 days per week for 102 cm - Men; > 88 cm - Women CVD EXERCISE Comorbidities of HTN, DM, dyslipidemia Aerobic exercise has a huge Increased pro-inflammatory impact on decreasing cytokines abdominal fat Increased cytokines: TNF-a associated with arterial stiffness Exercisers seem to have less Increased fat mass increases TPR inflammatory cytokines because of the extra vascular bed necessary to perfuse the tissue Lower resting SNS Fat deposition in myocardium and around kidneys impairs function.  DYSLIPIDEMIA: total cholesterol ≥ 200; LDL ≥130; HDL ≤ 40 mg/dl; triglycerides